May 16 2011

IVF Part Six: Transfer and the Two Week Wait

Published by at 2:32 pm under Infertility,IVF,The Man

The first part of getting ready for transfer is to start progesterone in oil injections the day after retrieval is done. These are the injections that everyone who is going through IVF tends to fear. If you search them on the internet, you will find horror story upon horror story of painful shots that leave welts and terrible soreness. When you consider the fact that you have to do these shots for TEN WEEKS if you get pregnant, no wonder people look on them with dread. I wanted to minimize my suffering as much as possible, so I combed the internet for tips.

First of all, I had one of my nurses draw a circle in the target area where the shot has to be administered. On the night we did the first injection, we prepared the syringe and then recapped it and wrapped it in a hot washcloth to warm the oil. I also put a hot washcloth on the injection site to warm my muscles. The Man iced down the injection site slightly just before giving me the shot. He put the needle in quickly, slowly injected the contents, and then pulled the needle out slowly. Afterwards, I massaged the injection site and walked around for awhile to work the muscle and help disperse the oil. The next day I had very slight soreness at the injection site, but no lumps or welts. The only discomfort I experienced during the injection was the initial small poke and then a slight stinging as the oil was slowly injected.

The major problem with the progesterone in oil injection is that it is, in fact, oil. It doesn’t disperse quickly like the other injections you have to have, which are thin liquid like water. If you don’t work at helping it disperse through the muscle, it WILL just sit there and form an uncomfortable lump. Warming the oil thins it slightly as well, making this dispersal easier. I don’t doubt that some people will have discomfort no matter what – everyone responds to things differently – but make it as easy on yourself as you can.

My transfer took place three days after my retrieval, which is pretty standard. The doctors retrieved eight eggs, seven of which were mature, and five of which successfully fertilized into viable embryos. Of those five, two were transferred and three were put into cryogenic storage.

At 7:30 AM on the day of transfer (May 19, 2011), I started drinking my water and took two 5 mg Valium. We reported to the doctor’s office at 8:00 AM for an 8:30 procedure time. Just like for retrieval, I had to put on a gown and footies and go into the prep/recovery room. Kris came in and asked if I was feeling “loopy” from the Valium. I told her no, because I felt normal. So, she had me take the other two 5 mg Valiums that I brought along. We had to do some paperwork, signing a basic consent and then another consent saying that Dr. Singh was going to transfer two embryos and freeze three. Then he handed us a picture of the two embryos that were going to get transferred. That was pretty surreal: looking at two little globs of cells that might one day be our children.

After a little while, I was walked back to the procedure room. The Man came along with me and sat in a chair next to my bed the whole time, which was nice. There was a little hitch with the ultrasound machine, which didn’t want to cooperate, but after a hard reboot, it got into the game.  The procedure itself was like having an IUI or a PAP smear. There wasn’t any pain, and there was just a little wait after the catheter was in while they retrieved the embryos. Once the embryos were transferred, there was another little wait while they verified that they hadn’t gotten stuck in the catheter and had actually transferred. Then they wheeled me into recovery, where I got to lay with my head slanted down for about 45 minutes.

After the 45 minutes had passed, I was allowed to go to the bathroom, get dressed, and leave. I was on bed rest for the rest of the day. Once we got back to the hotel, the Valium finally kicked in and I slept for several hours. Once I woke up, I quickly reached the conclusion that bed rest is pretty boring. I could get up to go to the bathroom, but otherwise I was stuck in the bed, watching TV, working online, or reading books. Not really a problem if I’m at home with all my recorded shows, movies, and library, but in a hotel? Ugh.

The next day I was able to get up and move around some, although I was still supposed to be “taking it easy”. It was a big relief to sit in a chair and be able to stretch my legs for a bit when I wanted. I didn’t really have any symptoms or pain, aside from a couple episodes of mild menstrual-like cramps. I figured that was from the procedure the day before. Mostly, I spent the day instructing myself to settle in for “the long wait”. My pregnancy test was scheduled for May 31.

For the first week of the wait, I experienced intermittent cramping nearly every day. These were just like strong (for me) menstrual cramps. Of course, this really freaked me out until I looked online and discovered that this is actually a very common symptom, and as long as it’s not accompanied by spotting is really nothing to worry about. The nurses had told me that the difference between me being miserable and me feeling OK during this time period was to keep drinking protein shakes and a lot of water. I had really slacked on this for a couple of days, which might have contributed to the cramping.

Is there any way that anyone has found to make this wait pass with a minimum of anxiety? I alternated between my pessimistic thoughts that the procedure hadn’t worked, to feeling guilty for not having enough faith in God to lead me to the proper outcome (whatever that might be), to trying to force myself into a positive mindset by making baby items. I read and re-read WSU’s success rate report (78% for fresh transfers for women under 35) and tried to tell myself that we had done everything we could to ensure success.

One other thing we did during this time was refine our progesterone in oil injection procedure. We bought a heating pad, which really made a huge difference. I would heat the injection site for about 10 minutes beforehand. The filled syringe would also be heating under the pad next to me at the same time. After injection, I heated the site again for 10 more minutes. This really helped reduce the soreness and bruising.

I would have to say that for me, the biggest problem with the “two week wait” is that we went from a lot of activity down to almost none. During the stimulation/retrieval/transfer part of things, you’re doing quite a lot. I had doctor’s appointments every day where I got an ultrasound and blood work. I got a call every day telling me if my meds were going to be adjusted. Every night, I had to inject myself multiple times and sometimes take a pill on top of that. But once transfer is complete, you’re shoved right onto bed rest and then you’re left with only one lonely injection to administer every night. During the busy time, there was a definite feeling of energy, accomplishment, and purpose: “OK! Things are getting done! I am doing things to help this situation progress!” There were also daily updates reassuring me that everything was going well, that things were going just as planned. During the wait period, there is none of that. There is really nothing you can do to help things along, and there is no reassurance that things are going the way that they should. You have absolutely no indication as to whether or not all of that work paid off until two weeks after retrieval, when you take your blood pregnancy test.

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

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